Making a Case for Sanctuary Hospitals

Saadi, Altaf; Ahmed, Sameer; Katz, Mitchell H.

doi:10.1001/jama.2017.15714

Cited by 34 publications

(21 citation statements)

References 5 publications

(7 reference statements)

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“…14,15 As a consequence, some health care facilities, such as hospitals and clinics, are adopting policies and actions to welcome immigrants, address immigration status-related stressors, and mitigate fears associated with accessing health care services. These efforts are embedded within a larger social and political landscape that includes media reports of immigration enforcement actions at or near health care facilities 16 and state or city sanctuary policies limiting the involvement of local law enforcement agencies with federal immigration enforcement agencies. 16 The ways in which health care facilities are responding to the increased enforcement of immigration policies has been discussed in media and medical literature editorials but has not been empirically studied.…”

Section: Introductionmentioning

confidence: 99%

“…These efforts are embedded within a larger social and political landscape that includes media reports of immigration enforcement actions at or near health care facilities 16 and state or city sanctuary policies limiting the involvement of local law enforcement agencies with federal immigration enforcement agencies. 16 The ways in which health care facilities are responding to the increased enforcement of immigration policies has been discussed in media and medical literature editorials but has not been empirically studied. This study offers a systematic multistate exploration of institutional policies and actions undertaken to mitigate perceived risks among patients who are immigrants and health care practitioners.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Perspectives on Health Care System Efforts to Mitigate Perceived Risks Among Immigrants in the United States

et al. 2020

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IMPORTANCE Increases in the enforcement of immigration policies, deportations, and rhetoric critical of immigration during and after the 2016 US presidential election have been associated with a decrease in health-seeking behaviors and an increase in adverse health outcomes among immigrants. Efforts to address the health care needs of immigrants after the 2016 presidential election have centered on individual-level patient-practitioner strategies or federal-and state-level policy changes. However, these approaches have not captured the role of health care systems and the range of health care facilities encompassed within them.OBJECTIVE To characterize policies and actions implemented by health care facilities to address immigration status-related stressors. DESIGN, SETTING, AND PARTICIPANTSThis exploratory qualitative study involved semistructured interviews in a purposive sample of health care facilities across 5 states (California, Texas, New York, Florida, and Illinois) with the largest populations of individuals with undocumented immigration status. Data from media sources and informational interviews with local immigration advocacy leaders were used to identify health care facilities that had implemented welcoming policies and strategies. Stakeholders, including administrators, frontline clinicians involved in policy implementation, and senior executive leaders, were interviewed. Interviews were conducted between May 1 and August 9, 2018, and were recorded, transcribed, and coded using constant comparative analysis. Data analysis was performed from MAIN OUTCOMES AND MEASURES Stakeholder perspectives on the range, scope and content of policies and actions implemented to address immigration-related stressors at health care facilities.RESULTS A total of 38 in-depth interviews were conducted spanning 25 health care facilities in 5 states; these facilities included 13 federally qualified health centers, 7 academic or private hospitals, and 5 public institutions. Interviewees described policies and actions that mitigated one or more of the following perceived risks: (1) risk of exposure to immigration enforcement personnel at or near facilities, (2) risk of immigration status-related information disclosure, (3) risk associated with patient-level stressors, (4) risk associated with practitioner-level stressors, and (5) coordination of risk mitigation. Most personnel at health care facilities emphasized that their policies and actions fit within a larger mission and history of addressing the social needs of diverse patients and mitigating risks for patients. CONCLUSIONS AND RELEVANCEHealth care facilities can implement both active and reactive measures to address perceived immigration-associated risks among patients and practitioners.Population health and immigration policies are at the forefront of current policy debates. An (continued) Abstract (continued) understanding of the ways in which health care facilities can serve to mitigate perceived risks among their patients and employees can be one step toward ...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of Perspectives on Health Care System Efforts to Mitigate Perceived Risks Among Immigrants in the United States

et al. 2020

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“…Anna and her mother, Ms P, represent millions of families struggling amid a changing immigration landscape marked by increased anti-immigrant sentiment and immigration enforcement since the 2016 presidential election. 1 Clinicians are being confronted with this reality as they care for an estimated 11.4 million undocumented immigrants living in the United States 2 and their family members and friends. Moreover, an estimated 5.1 million children in the United States under the age of 18 have at least one undocumented parent, and the majority of them are citizens by birth (79%) 3 ; roughly 1 in 14 children live in families with mixed immigration status.…”

Section: Commentarymentioning

confidence: 99%

Should Immigration Status Information Be Included in a Patient's Health Record?

2019

AMA Journal of Ethics

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“…In addition to the core principles of traumainformed care, relevant for this highly trauma-exposed population, components of ''immigration-informed care'' include appropriate language services, clearly delineated referral pathways for undocumented patients, culturally and structurally competent clinicians trained to discuss sensitive topics without inciting fear, 20,21 and institutional policies that ensure the physical and psychological safety of immigrant patients, such as avoiding documentation of immigration status in medical records and limiting cooperation with law enforcement. 22,23 Consequently, immigration-informed care would have a positive impact on patient care and patient-clinician partnerships as has the traumainformed approach. 24 Furthermore, an ''immigration-informed'' clinician understands migration as a continuum of experiences with a variety of stressors, including violence, sexual assault, and other trauma both in an individual's home country and during migration.…”

Section: Adopt the Concept Of ''Immigration-informed Care''mentioning

confidence: 99%

Building Immigration-Informed, Cross-Sector Coalitions: Findings from the Los Angeles County Health Equity for Immigrants Summit

et al. 2019

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In December 2017, the Los Angeles County Office of Immigrant Affairs and Board of Supervisors, alongside local health care and legal providers, convened the Health Equity for Immigrants and Families Summit to advance a vision for immigrant health. We describe the four critical concepts identified by stakeholders to address the varied needs of immigrants in an increasingly anti-immigrant political environment: (1) Recognizing immigration status as a modifiable social determinant of health; (2) Adopting the concept of ''Immigration-Informed Care'' within health care institutions; (3) Establishing immigration-focused medical-legal partnerships; and (4) Building coordinated systems based on knowledge of local stakeholders, policies, and funding mechanisms.

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Making a Case for Sanctuary Hospitals

Cited by 34 publications

References 5 publications

Assessment of Perspectives on Health Care System Efforts to Mitigate Perceived Risks Among Immigrants in the United States

Assessment of Perspectives on Health Care System Efforts to Mitigate Perceived Risks Among Immigrants in the United States

Should Immigration Status Information Be Included in a Patient's Health Record?

Building Immigration-Informed, Cross-Sector Coalitions: Findings from the Los Angeles County Health Equity for Immigrants Summit

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